Pandemic still threat to young, expert says

GENEVA (Reuters) - The H1N1 flu pandemic is as severe as influenza pandemics in 1957 and 1968 and remains a threat, especially to healthy young adults, a leading health expert said on Wednesday.

John Mackenzie, the Australian who heads the World Health Organisation's independent but secretive Emergency Committee, also said he was not aware of any of its 15 members being approached by drug companies seeking to influence their decision-making.

"This is just as severe as we saw in 1957 and 1968, with one major difference. We are not seeing deaths in the elderly but we are seeing them in a more important group of the population, healthy young adults," Mackenzie said in a rare presentation.

"It is much more severe than people tend to talk about," he told a three-day meeting called to review the way the WHO handled the pandemic.

The official death toll so far from H1N1 is 17,700, but the WHO says it will take at least a year or two after the pandemic ends to establish the true number.

The 1957 and 1968 pandemics killed about 2 million and 1 million people respectively, according to the WHO. Seasonal flu kills up to 500,000 a year, 90 percent of them frail elderly people.

The Emergency Committee played a key role in advising the U.N. agency on progressively moving up its six-phase scale, leading to the declaration of a full pandemic last June.

Phase changes have implications for switching from production of seasonal flu vaccine to pandemic vaccine. Moving to phase 6 also triggered advance purchase agreements that some Western countries had with drug companies.

Swine flu has turned out to be less severe than feared, and critics have said the WHO created needless panic and caused Western governments to stockpile vaccines that were unused.

Mackenzie said he expected the committee to convene again in two or three weeks to advise WHO Director-General Margaret Chan on whether the world has moved to a post-peak phase. He indicated that such a decision remained premature.

"STILL IN A PANDEMIC"

"We still have evidence of the pandemic in Asia and in West Africa," he said. "We also want to see what happens in a second wave in the southern hemisphere. We have no idea what will happen and have some concerns.

Mackenzie said the committee had taken unanimous decisions on difficult issues based on the evidence available.

"I as chairman was not approached at any stage by the pharmaceutical industry. I don't know of any member being approached and I would very much doubt it," he said.

"We did not want to see production of seasonal vaccine discontinued if the pandemic was going to disappear."

No Emergency Committee members apart from Mackenzie are identified publicly, a policy intended to protect them from commercial or political influence.

The committee reviewing the WHO's handling of the pandemic would consider whether the WHO's alert system should reflect severity as well as spread, and the terminology such as swine flu to describe the virus, its chairman, Dr Harvey Fineberg, said.

The committee will produce an interim report in time for next month's WHO World Health Assembly, and aims to conclude it by next January's WHO Executive Board meeting.

"We're not here either to defend or to prosecute the WHO, that's not our job. We're here to find out as best we can, in as truthful way we can what are the lessons that can be learnt," Fineberg told a news conference after the three-day meeting.

David Salisbury, head of the WHO's vaccine advisory body, the Scientific Advisory Group for Emergencies (SAGE), said it had become clear only last October that a single dose of vaccine would be sufficient to provide immunity for adults, and not two as generally expected.

GlaxoSmithKline and Sanofi-Aventis are among firms that have raced to produce H1N1 vaccines.